Patient-reported Outcome Measures and Decision Regret After Prostate-specific Membrane Antigen–targeted Radioguided Surgery for Oligorecurrent Prostate Cancer

Background and objective: In patients with oligorecurrent prostate cancer (PCa), prostate-specific membrane antigen–targeted radioguided surgery (PSMA-RGS) prolongs treatment-free survival. Data on patient-reported outcome measures (PROMs) are lacking. Methods: A retrospective assessment of validate...

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Main Authors: Fabian Falkenbach, Giovanni Mazzucato, Zhe Tian, Pierre I. Karakiewicz, Markus Graefen, Thomas Steuber, Derya Tilki, Daniel Koehler, Burkhard Beyer, Pierre Tennstedt, Sophie Knipper, Lars Budäus, Tobias Maurer
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:European Urology Open Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666168324010851
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author Fabian Falkenbach
Giovanni Mazzucato
Zhe Tian
Pierre I. Karakiewicz
Markus Graefen
Thomas Steuber
Derya Tilki
Daniel Koehler
Burkhard Beyer
Pierre Tennstedt
Sophie Knipper
Lars Budäus
Tobias Maurer
author_facet Fabian Falkenbach
Giovanni Mazzucato
Zhe Tian
Pierre I. Karakiewicz
Markus Graefen
Thomas Steuber
Derya Tilki
Daniel Koehler
Burkhard Beyer
Pierre Tennstedt
Sophie Knipper
Lars Budäus
Tobias Maurer
author_sort Fabian Falkenbach
collection DOAJ
description Background and objective: In patients with oligorecurrent prostate cancer (PCa), prostate-specific membrane antigen–targeted radioguided surgery (PSMA-RGS) prolongs treatment-free survival. Data on patient-reported outcome measures (PROMs) are lacking. Methods: A retrospective assessment of validated PROMs (12-item Short Form Health Survey [SF-12], 26-item Expanded Prostate Index Composite, and Decision Regret Scale [DRS]) was performed before and after PSMA-RGS for oligorecurrent PCa. Mixed models were used. Key findings and limitations: A total of 373 patients were analyzed at a median (interquartile range [IQR]) age of 66 (61, 70) yr and prostate-specific antigen of 0.8 (0.4, 1.5) ng/ml. Six months after PSMA-RGS, the median (IQR) scores for the PROMs were as follows: SF-12 physical 54 (49, 56), SF-12 mental 53 (43, 56), urinary incontinence 86 (52, 100), urinary irritation 94 (88, 100), sexual 27 (9, 57), hormonal 90 (79, 100), and bowel 96 (83, 100). Only the sexual score decreased in a significant fashion from baseline over time (median [IQR], 17 [8,38]) after 3 yr vs 37 [13, 63] at baseline, p = 0.01). The decision regret remained low (median [IQR] DRS at 1 yr: 5 [0, 20]). More than 90% of the patients reported that PSMA-RGS was the correct decision after 1 yr. Conclusions and clinical Implications: We recorded no significant decrease in quality of life or any functional status domain, except sexual. While decision regret was low, sexual functioning might deteriorate further. Patient summary: No significant deterioration in health-related quality of life was reported after removing early prostate cancer metastases. Very few patients expressed remorse about their decision for salvage surgery.
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spelling doaj-art-eae709c66f0d464ab1a9165bf132e8402025-08-20T02:07:17ZengElsevierEuropean Urology Open Science2666-16832024-12-01701710.1016/j.euros.2024.09.010Patient-reported Outcome Measures and Decision Regret After Prostate-specific Membrane Antigen–targeted Radioguided Surgery for Oligorecurrent Prostate CancerFabian Falkenbach0Giovanni Mazzucato1Zhe Tian2Pierre I. Karakiewicz3Markus Graefen4Thomas Steuber5Derya Tilki6Daniel Koehler7Burkhard Beyer8Pierre Tennstedt9Sophie Knipper10Lars Budäus11Tobias Maurer12Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaMartini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, ItalyCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaMartini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyMartini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyMartini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyMartini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Urological Competence Center for Rehabilitation Wildetal, Bad Wildungen, GermanyMartini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyMartini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Vivantes Klinikum am Urban, Berlin, GermanyMartini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyMartini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Corresponding author. Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany. Tel. +49 152 2280 5506.Background and objective: In patients with oligorecurrent prostate cancer (PCa), prostate-specific membrane antigen–targeted radioguided surgery (PSMA-RGS) prolongs treatment-free survival. Data on patient-reported outcome measures (PROMs) are lacking. Methods: A retrospective assessment of validated PROMs (12-item Short Form Health Survey [SF-12], 26-item Expanded Prostate Index Composite, and Decision Regret Scale [DRS]) was performed before and after PSMA-RGS for oligorecurrent PCa. Mixed models were used. Key findings and limitations: A total of 373 patients were analyzed at a median (interquartile range [IQR]) age of 66 (61, 70) yr and prostate-specific antigen of 0.8 (0.4, 1.5) ng/ml. Six months after PSMA-RGS, the median (IQR) scores for the PROMs were as follows: SF-12 physical 54 (49, 56), SF-12 mental 53 (43, 56), urinary incontinence 86 (52, 100), urinary irritation 94 (88, 100), sexual 27 (9, 57), hormonal 90 (79, 100), and bowel 96 (83, 100). Only the sexual score decreased in a significant fashion from baseline over time (median [IQR], 17 [8,38]) after 3 yr vs 37 [13, 63] at baseline, p = 0.01). The decision regret remained low (median [IQR] DRS at 1 yr: 5 [0, 20]). More than 90% of the patients reported that PSMA-RGS was the correct decision after 1 yr. Conclusions and clinical Implications: We recorded no significant decrease in quality of life or any functional status domain, except sexual. While decision regret was low, sexual functioning might deteriorate further. Patient summary: No significant deterioration in health-related quality of life was reported after removing early prostate cancer metastases. Very few patients expressed remorse about their decision for salvage surgery.http://www.sciencedirect.com/science/article/pii/S2666168324010851Salvage surgeryBiochemical recurrenceProstate-specific membrane antigen positron emission tomographyImaging-guided surgeryQuality of lifePatient-reported outcome measures
spellingShingle Fabian Falkenbach
Giovanni Mazzucato
Zhe Tian
Pierre I. Karakiewicz
Markus Graefen
Thomas Steuber
Derya Tilki
Daniel Koehler
Burkhard Beyer
Pierre Tennstedt
Sophie Knipper
Lars Budäus
Tobias Maurer
Patient-reported Outcome Measures and Decision Regret After Prostate-specific Membrane Antigen–targeted Radioguided Surgery for Oligorecurrent Prostate Cancer
European Urology Open Science
Salvage surgery
Biochemical recurrence
Prostate-specific membrane antigen positron emission tomography
Imaging-guided surgery
Quality of life
Patient-reported outcome measures
title Patient-reported Outcome Measures and Decision Regret After Prostate-specific Membrane Antigen–targeted Radioguided Surgery for Oligorecurrent Prostate Cancer
title_full Patient-reported Outcome Measures and Decision Regret After Prostate-specific Membrane Antigen–targeted Radioguided Surgery for Oligorecurrent Prostate Cancer
title_fullStr Patient-reported Outcome Measures and Decision Regret After Prostate-specific Membrane Antigen–targeted Radioguided Surgery for Oligorecurrent Prostate Cancer
title_full_unstemmed Patient-reported Outcome Measures and Decision Regret After Prostate-specific Membrane Antigen–targeted Radioguided Surgery for Oligorecurrent Prostate Cancer
title_short Patient-reported Outcome Measures and Decision Regret After Prostate-specific Membrane Antigen–targeted Radioguided Surgery for Oligorecurrent Prostate Cancer
title_sort patient reported outcome measures and decision regret after prostate specific membrane antigen targeted radioguided surgery for oligorecurrent prostate cancer
topic Salvage surgery
Biochemical recurrence
Prostate-specific membrane antigen positron emission tomography
Imaging-guided surgery
Quality of life
Patient-reported outcome measures
url http://www.sciencedirect.com/science/article/pii/S2666168324010851
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